In breech presentation, where is the fetal heart rate best heard?

In breech presentation, where is the fetal heart rate best heard?

• A. At or above the level of the maternal umbilicus
• B. In the lower quadrant of the abdomen
• C. In the left lower quadrant
• D. At the xiphoid process

Answer: (A)

In breech presentation, where the fetus is presenting buttocks or feet rather than the head, the fetal chest sits higher in the uterus, closer to the fundus. Because of this, the strongest fetal heart signals are found higher in the abdomen, near or above the level of the maternal umbilicus. Listening lower down in the abdomen is less reliable in this position. So the best place to auscultate the fetal heart rate when breech is at or above the level of the maternal umbilicus. The heart sound is not most reliably heard near the xiphoid process or in the lower quadrants in breech, since the presenting part is occupying the lower uterine segment and shifts the heartbeat higher up.

In breech presentation, where the fetus is presenting buttocks or feet rather than the head, the fetal chest sits higher in the uterus, closer to the fundus. Because of this, the strongest fetal heart signals are found higher in the abdomen, near or above the level of the maternal umbilicus. Listening lower down in the abdomen is less reliable in this position. So the best place to auscultate the fetal heart rate when breech is at or above the level of the maternal umbilicus. The heart sound is not most reliably heard near the xiphoid process or in the lower quadrants in breech, since the presenting part is occupying the lower uterine segment and shifts the heartbeat higher up.